• Promoting practitioner research through a social work teaching partnership

      Buck, Gillian; Whiteside, Nicola; Newman, Andrea; Jones, Helen; Stanley, Selwyn; Feather, Julie; Millard, Wayne; University of Chester; Cheshire and Merseyside Social Work Teaching Partnership; Liverpool John Moores University; Warrington Borough Council; Edge Hill University
      Research is critical for effective and innovative social work practice, yet social workers do not always have time to engage with research and there are limited accounts of how practitioners can undertake research in practical and meaningful terms (Mitchell, Lunt, and Shaw 2010). Using a reflective, storytelling methodology (Beresford 2016), which centres experiential knowledge, we describe how one regional social work teaching partnership nurtured practitioner research over a three-year period. We introduce a regionally administrated ‘hub’, that connected social workers and academics and supported the development of seventeen research teams. The studies that resulted, focused on a range of important issues including child protection, young people in transition to adult services, adults in community and residential settings, lived experience-led provision, and social work education. In terms of limitations, our reflections are descriptive and illuminative, rather than critical, our findings are also not representative but rather reflect a snapshot of practice. Despite limitations, this commentary reveals the feasibility and value of proactively nurturing practitioner research and offers a blueprint for cultivating similar initiatives in other regions.
    • Understanding the contribution of intellectual disability nurses: Scoping research. Volume 3 of 3 – Compendium of intellectual disability nursing interventions.

      Mafuba, Kay; Chapman, Hazel M.; Kiernan, Joann; Kupara, Dorothy; Chester, Rebecca; Kudita, Chiedza; City University, London; University of Chester; Edge Hill University; Berkshire Healthcare NHS Foundation Trust
      Introduction The RCN Foundation commissioned the University of West London and their collaborators to undertake scoping research on understanding the contribution of nurses to improve the health and well-being of children, adults and older people with intellectual disabilities (ID), now and for the future. The overall aim of the research was to identify nursing led and or nursing centred interventions that address the challenging and changing needs of people with ID. This, the ‘Compendium of ID nursing interventions’ provides a catalogue of these interventions. The research project report is in three volumes; Volume 1/3: Scoping literature review report; Volume 2/3: Scoping survey research report; and Volume 3/3: Compendium of intellectual disabilities nursing interventions (this volume). Methods In phase 1 of the project, we undertook a scoping literature review using the Joanna Briggs Institute’s (JBI) scoping review protocols. We used the PRISMA-ScR process and JBI guidance to select the literature for review and to present the literature review report (Trico, et al., 2018; Peters, et al., 2017). A mixed methods approach to the review and synthesis was used due to the heterogeneous nature of the evidence. JBI tools were used to pool findings and rate them for quality. Thematic synthesis was used to generate analytical themes. Empirical (quantitative, qualitative, mixed methods) studies, synthesised evidence (literature reviews) and opinion papers, (n = 52) were included in the review (see volume 1 of the report). In phase 2 of the project, we undertook an online survey to collect quantitative and qualitative data. There were 230 participants from 7 countries. We used thematic, and content analyses to analyse qualitative data. We undertook descriptive and inferential analyses of quantitative data (see volume 2 of the report) Emerging ID nursing interventions In total we identified 925 interventions. In phase 1 we identified 154 ID nursing interventions, and in phase 2 we identified 878 interventions. The discrepancy in the total numbers is that interventions which appeared in both phases are only recorded once. In phase 2, these interventions were undertaken in a wide range of settings and across the lifespan. We categorised the interventions into five themes; effectuating nursing procedures, enhancing impact of ID services, enhancing impact of mainstream services, enhancing quality of life, and enhancing ID nursing practice. We have merged the interventions we identified in the literature review and from the table below. We have removed duplicates and merged the evidence sources where appropriate.
    • Understanding the contribution of intellectual disability nurses: Scoping research Volume 2 of 3: Scoping survey research report

      Mafuba, Kay; Chapman, Hazel M.; Kiernan, Joann; Kupara, Dorothy; Chester, Rebecca; Kudita, Chiedza; University of West London; University of Chester; Edge Hill University; Berkshire Healthcare NHS Foundation Trust
      Introduction This scoping research identifies nursing-led and or nursing centred interventions that are in place to address the changing needs of people with intellectual disabilities (ID). Aims The aim of the research is to identify nursing-led and / or nursing centred interventions that are in place to address the challenging and changing needs of people with ID. The research identifies interventions, that can be implemented by nurses working in multi-disciplinary teams. The research also identifies areas of good care delivery, innovative practices, and possible gaps in the provision of care for individuals with intellectual disabilities. Methods We undertook an online survey to collect quantitative and qualitative data. We used voluntary response sampling to collect data from 230 participants from 7 countries. Participants were primarily registered intellectual disabilities nurses working with people with ID. We used thematic, and content analyses to analyse qualitative data. We undertook descriptive and inferential statistical analyses of quantitative data, specifically we undertook Pearson correlations and Pearson Chi-square analyses. Results We identified 878 interventions from 7 countries. These interventions were undertaken in a wide range of settings and across the lifespan (maternity (4), children (156), adults (384), older adults (129), all age groups (393) and end of life (19). We categorised the interventions into five themes; effectuating nursing procedures, enhancing impact of ID services, enhancing impact of mainstream services, enhancing quality of life, and enhancing ID nursing practice. We identified several case studies that demonstrate the positive impact of ID nursing interventions. Conclusions ID nurses implement a wide range of emerging interventions working in multi-disciplinary teams. They practice in a wide range of settings in the UK and other countries. More work is needed in order to better understand the reasons for the limited involvement of ID nurses with pregnant women with IDs and in end-of-life care. The variation in understanding the interventions undertaken by ID nurses between countries need to be further investigated.
    • Understanding the contribution of intellectual disability nurses: Scoping research - Volume 1 of 3: Scoping literature review report

      Mafuba, Kay; Forster, Marc; Chapman, Hazel M.; Kiernan, Joann; Kupara, Dorothy; Chester, Rebecca; Kudita, Chiedza; University of West London; University of Chester; Edge Hill University; Berkshire Healthcare NHS Foundation Trust
      Introduction This scoping review of literature is the first part of a 3-phase project. The RCN Foundation commissioned the University of West London and their collaborators to undertake scoping research on understanding the contribution of nurses to improving the health and well-being of children, adults and older people with intellectual disabilities, now and for the future. The overall aim of the research is to identify nursing-led and / or nursing centred interventions that are in place to address the challenging and changing needs of people with intellectual disabilities. The research sought to identify interventions, that can be implemented by nurses working in multi-disciplinary teams. The research identifies areas of good care delivery, any innovative practices, and possible gaps in the provision of care for individuals with intellectual disabilities. Objective The overall objective of this review is to summarise evidence on the contribution of intellectual disability nurses to improve the health and well-being of children, adults and older people with intellectual disabilities, now and for the future. Methods We searched the Joanna Briggs Institute (JBI) Reports, Medline, Embase, PsycINFO, CINAHL, Academic Search Elite, ProQuest Dissertations and Theses (Global) also known as Index to Theses, ETHOS, UK Government publications, and professional organisations’ publications. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (for Scoping Reviews) (PRISMA-ScR) process and Joanna Briggs Institute (JBI) guidance was used to select the literature for review and to present the literature review report (Tricco et al., 2018; Peters et al., 2017). A mixed methods approach to the review and synthesis was used due to the heterogeneous nature of the evidence. JBI tools were used to rate studies for quality. Thematic synthesis was used to generate analytical themes. Results We retrieved 121 publications. Of these we excluded 35 after initial appraisal. We appraised 86 publications and excluded 33 after appraisal and we included 53 publications in this review. We identified a wide range of interventions (154) performed by intellectual disability nurses in a variety of settings across the lifespan. We categorised the intellectual disability nursing interventions into three themes; effectuating nursing procedures, enhancing impact of services, and enhancing quality of life. The majority of publications reported cross-sectional studies (77%), 6% of publications were literature reviews, and 17% were opinion papers. Only two of the primary studies investigated the effectiveness of intellectual disability nurse interventions. The majority of the publications focused on interventions related to adults (31). Not all publications focussed on a particular age group. One publication referred to maternity, five focussed on interventions relevant to children, ten identified interventions relevant to all age groups, five focussed on older adults, five focussed on end of life interventions and one publication was not clear. Conclusions We identified 154 interventions performed by intellectual disability nurses in a variety of settings. We categorised the interventions into three themes; Effectuating nursing procedures (52 interventions), Enhancing impact of services (73 interventions), and Enhancing quality of life (41 interventions). Publications identifying the interventions performed by intellectual disability nurses in relation to maternity, children, older adults and end of life care were limited. Publications did not demonstrate the impact and effectiveness of interventions. This advocates for high quality research being essential in determining the impact and effectiveness of intellectual disability nursing interventions across the lifespan. We recommend that a searchable online compendium of intellectual disability nurse interventions be established and regularly reviewed.
    • Social work students and dyslexia: outcomes from an empirical study and some implications for practice

      Gant, Valerie; Hewson, Michael; University of Chester (Taylor and Francis, 2022-09-07)
      Dyslexia is likely one of the most misunderstood conditions impacting on educational outcomes at all levels, in and across all practice and intellectual domains. This paper discusses a project carried out by two qualified social workers, one an academic involved in teaching and assessing social work students, the other a doctoral student with a formal diagnosis of dyslexia and dyspraxia. The research involved 9 social work students from 3 different universities who identified as having dyslexia. Semi structured interviews were held in order to identify challenges experienced by participants as well as any strategies they used to ameliorate them. The data from the interviews was coded and analysed, the findings indicated a range and variety of experiences. Participants described feeling anxious and questioned their ability to study social work, both in university and on placement. Feelings of exhaustion were noted, which indicated the need to examine and potentially to rebalance educators’ expectations across academic and practical roles, and to provide support for students to meet workload requirements particularly when on placement. Findings from the interviews were shared with academic staff and practice educators, additionally a ‘good practice’ guide was produced to support educators in placement as well as in universities
    • How many practice hours are required to become a registered nurse?

      Garrow, Amanda; Roberts, Deborah; Kenny, Amanda; Leigh, Jackie; Borwell, Juliet; Knight, Kate H; Whaley, Victoria; Monks, Rob; Wright, Karen; University of Chester; Liverpool John Moores University; University of Bradford; La Trobe University; Edge Hill University; Health Education England
      Globally, the number of nurse vacancies is high, and there has been much scrutiny on the preparation of the nursing workforce. The World Health Organization (2020) has called for an acceleration of nurse education to meet future demands. In the UK, nursing is at a critical juncture. Post-pandemic attrition rates are high and, despite ambitious government targets, recruitment is unable to meet demand. A Nursing and Midwifery Council (NMC) report (NMC, 2022a) demonstrated that almost half the number of graduate nurses joining the register for the first time (48% of 48 436) completed nurse education outside the UK. Of this group, 66% were educated in India or the Philippines. Nurse education in the UK is approved
    • Psychological Therapies and Non-Suicidal Self Injury in LGBTIQ in Accident and Emergency Departments in the UK: A scoping review

      Broadway-Horner, Matthew; Kar, Anindya; Ventriglio, Antonio; Pemberton, Max; University of Chester; Advanced Neuropsychiatry Institute, Kolkata; Camden and Islington Foundation NHS Trust; University of Foggia (Taylor and Francis, 2022-08-25)
      Background: To identify psychological interventions that improve outcomes for those who overdose, especially amongst Lesbian, Gay, Bisexual, Transgender, Intersex and Questioning populations. Objective: To recognise and assess the results from all studies including randomised control trials that have studied the efficiency of psychiatric and psychological assessment of people who have depression that undergo Non-Suicidal Self Injury (NSSI) by self-poisoning, presenting to UK A & E Departments Method: A scoping review of all studies including randomised controlled trials of psychiatric and psychological therapy treatments. Studies were selected according to types of engagement and intervention received. All studies including Randomised Controlled Trials (RCTs) available in databases since 1998 in the Willey version of the Cochrane controlled trials register in 1998 till 2021, Psych INFO, Medline, Google Scholar and from manually searching of journals were included. Studies which included information on repetition of NSSI behaviour were also included. Altogether this amounts to 3,900 randomised study participants with outcome data. Results: 7 trials reported repetition of NSSI as an outcome measure which were classified into 4 categories. Problem solving therapy (PST) is indicated as a promising therapy and has shown to significantly reduce repetition in participants who NSSI by overdosing than patients in the control treatment groups consisting of standard after care. Conclusion: The data shows that Manualised Cognitive Therapy (MACT) psychological intervention was more effective than TAU after care. However, these differences are not statistically significant with p = 0.15; CI 0.61, 1.0 which crosses the line of no effect. And Psychodynamic Interpersonal Therapy (PIT) is more effective than standard treatment. Despite being only one study in this subgroup the analysis shows a statistically Significance with p = 0.009, CI0.08; 0.7
    • Interactions between Vitamin D Genetic Risk and Dietary Factors on Metabolic Disease-Related Outcomes in Ghanaian Adults

      Alathari, Buthaina E.; Nyakotey, David A.; Bawah, Abdul-Malik; Lovegrove, Julie A.; Annan, Reginald A.; Ellahi, Basma; Vimaleswaran, Karani S.; University of Reading; The Public Authority for Applied Education and Training, Kuwait; Kwame Nkrumah University of Science and Technology; University of Auckland; University of Chester (MDPI, 2022-07-04)
      The Ghanaian population is experiencing an upsurge in obesity and type 2 diabetes (T2D) due to rapid urbanization. Besides dietary factors, vitamin D-related genetic determinants have also been shown to contribute to the development of obesity and T2D. Hence, we aimed to examine the interactions between dietary factors and vitamin D-related genetic variants on obesity and T2D related outcomes in a Ghanaian population. Three hundred and two healthy Ghanaian adults (25–60 years old) from Oforikrom, Municipality in Kumasi, Ghana were randomly recruited and had genetic tests, dietary consumption analysis, and anthropometric and biochemical measurements of glucose, HbA1c, insulin, cholesterol, and triglycerides taken. A significant interaction was identified between vitamin D-GRS and fiber intake (g/day) on BMI (pinteraction = 0.020) where those who were consuming low fiber (≤16.19 g/d) and carrying more than two risk alleles for vitamin D deficiency (p = 0.01) had a significantly higher BMI. In addition, an interaction between vitamin D-GRS and fat intake (g/day) on HbA1c (total fat, pinteraction = 0.029) was found, where participants who had a lower total fat intake (≤36.5 g/d), despite carrying more than two risk alleles, had significantly lower HbA1c (p = 0.049). In summary, our study has identified novel gene–diet interactions of vitamin D-GRS with dietary fiber and fat intakes on metabolic traits in Ghanaian adults.
    • Practicing lived experience leadership with love: Photovoice reflections of a community-led crime prevention project

      Buck, Gillian; Ryan, Kemi; Ryan, Natasha; University of Chester; Reformed, Liverpool (Oxford University Press, 2022-09-16)
      Lived experience leadership is part of a broader international trend toward service user involvement in public services yet little is known about services developed and delivered by people with lived experience of the criminal justice system. Our innovative study, coproduced by two formerly imprisoned community practitioners and an academic researcher, aims to amplify the voices of people delivering and using a lived experience-led crime prevention project. Using Photovoice methods, in which people use cameras to document their realities and advocate for change, we explore the potential of lived experience leadership to drive individual and social change. Some of the compelling images produced by the group are showcased, revealing how in contexts of suffering, social exclusion, and negative expectations, forms of inclusive, loving, hopeful community praxis can be impactful. We conclude that allegiances between community practitioners and social workers could begin to disrupt harmful and oppressive structures and create locally led, hope-filled service provision. To broker such allied practices, we include a self-audit for social and community workers, inviting reflections focused on this ambitious goal.
    • The Cost of Von Willebrand Disease in Europe: The CVESS Study

      Morgan, George; Brighton, Sarah; orcid: 0000-0003-3489-368X; email: sarah.brighton@hcdeconomics.com; Laffan, Mike; Goudemand, Jenny; Franks, Bethany; Finnegan, Alan (SAGE Publications, 2022-08-17)
      Background: Von Willebrand disease (VWD) is one of the most common inherited bleeding disorders, imposing a substantial health impact and financial burden. The Cost of von Willebrand disease in Europe: A Socioeconomic Study (CVESS) characterises the socio-economic cost of VWD across Germany, Spain, Italy, France, and the UK. Methods: A retrospective, cross-sectional design captured 12 months of patient disease management, collected from August-December 2018, for 974 patients. This enabled estimation of direct medical, direct non-medical and indirect costs, utilising prevalence estimates to extrapolate to population level. Results: Total annual direct medical cost (including/excluding von Willebrand factor [VWF]) across all countries was the highest cost (€2 845 510 345/€444 446 023), followed by indirect costs (€367 330 271) and direct non-medical costs (€60 223 234). Differences were seen between countries: the UK had the highest direct medical costs excluding VWF (€159 791 064), Italy the highest direct-non medical (€26 564 496), and Germany the highest indirect cost burden (€197 036 052). Total direct medical costs per adult patient increased across VWD types with Type 1 having the lowest cost (€23 287) and Type 3 having the highest cost (€133 518). Conclusion: A substantial financial burden arises from the prevalence of VWD for the European healthcare systems considered.
    • Older Trans Individuals’ Experiences of Health and Social Care and the Views of Healthcare and Social Care Practitioners: “They hadn’t a clue”

      Benbow, Susan M.; Kingston, Paul; University of Chester (Taylor and Francis, 2022-01-24)
      This study investigated older trans people’s experiences of health and social care, and the experiences and views of practitioners in order to inform service development. Sixteen trans adults aged over 50 from Cheshire and nearby were recruited via community organisations and interviewed individually or in focus groups. Interviews were audiotaped and transcribed with consent. Health and social care service practitioners were interviewed remotely or face-to-face. Data were analysed thematically supported by qualitative data analysis software. Three main themes were identified. ‘Levers’ indicated forces that influenced an individual’s contact with health and or social care positively or negatively, and encompassed five sub-themes: age; experiences good or bad; family/ close relationships; LGBT identity/ communities; and money/ finances. ‘Contextual forces’ encompassed societal forces that shape individuals’ encounters in care, lack the potential for positive influence, and are more closely allied to stereotypes/ myths: this theme included three sub-themes: discrimination/ hate; ignorance; and risk from others. ‘Positive practices’ encompassed five sub-themes, including learning/ training. In conclusion older age increases the importance of access to treatment for gender variance whilst simultaneously complicating it; older trans service users may be sensitive to potentially discriminatory experiences because of historical experiences; services should endeavour to understand individuals in the context of life history and psycho-social context; practitioners benefit from training in positive inclusive approaches to care; local community services are advantageous. Further research is needed with particular attention to social care, the experiences of trans men, and how to translate findings into person-centred practice, education and training.
    • Evaluation of Drinking Water Quality and Bacterial Antibiotic Sensitivity in Wells and Standpipes at Household Water Points in Freetown, Sierra Leone.

      Kamara, Dauda; orcid: 0000-0001-7750-8273; Bah, Doris; Sesay, Momodu; Maruta, Anna; orcid: 0000-0002-6417-7273; Sesay, Bockarie Pompey; Fofanah, Bobson Derrick; orcid: 0000-0003-3276-8949; Kamara, Ibrahim Franklyn; orcid: 0000-0003-1454-4650; Kanu, Joseph Sam; orcid: 0000-0003-0799-6907; Lakoh, Sulaiman; orcid: 0000-0002-7639-0004; Molleh, Bailah; et al. (2022-05-29)
      Water quality surveillance can help to reduce waterborne diseases. Despite better access to safe drinking water in Sierra Leone, about a third of the population (3 million people) drink water from unimproved sources. In this cross-sectional study, we collected water samples from 15 standpipes and 5 wells and measured the physicochemical and bacteriological water quality, and the antimicrobial sensitivity of <i>Escherichia coli</i> (<i>E. coli</i>) in two communities in Freetown, Sierra Leone in the dry and wet seasons in 2021. All water sources were contaminated with <i>E. coli</i>, and all five wells and 25% of standpipes had at least an intermediate risk level of <i>E. coli</i>. There was no antimicrobial resistance detected in the <i>E. coli</i> tested. The nitrate level exceeded the WHO's recommended standard (&gt;10 parts per million) in 60% of the wells and in less than 20% of the standpipes. The proportion of samples from standpipes with high levels of total dissolved solids (&gt;10 Nephelometric Turbidity Units) was much higher in the rainy season (73% vs. 7%). The level of water contamination is concerning. We suggest options to reduce <i>E. coli</i> contamination. Further research is required to identify where contamination of the water in standpipes is occurring.
    • Acceptability, usability and weight loss outcomes in a randomized cross-over study of commercially available portion size tools in an overweight South Asian community

      Ellahi, Basma; Aitken, Amanda; Dikmen, Derya; Erdogan, Bilge Seyhan; Makda, Munibah; Razaq, Rifat; University of Chester; Hacettepe University (MDPI, 2022-06-23)
      South Asian women living in the UK are particularly at high risk of obesity-related complications, such as type 2 diabetes and cardio-vascular disease. Exposure to large portion sizes is a risk factor for obesity. Specifically, designed tableware helps individuals to manage weight through controlling food portion sizes. Thirty-one (n=31) overweight or obese South Asian adult women participated in a randomised cross-over trial aimed to assess efficacy, acceptance and weight change for two guided/calibrated commercially available portion control tools (Utensil set and Crockery Set) used in free-living conditions. Data on acceptance, perceived changes in portion size, frequency, and meal type was collected using paper questionnaires and 3-day diet dairies. Scores describing acceptance, ease of use and perceived effectiveness were derived from five-point Likert scales from which binary indicators (high/low) were analysed for significance using multivariate variance analysis for repeated measurements. A reduction in BMI was observed at each point of measurement (p=0.007). For overall tool use, the crockery set scored higher in all areas of acceptance, ease of use, perceived efficacy for all comparisons. Self-selected portion sizes increased for salads and decreased for cooking oil and breakfast cereals with both tools. Further research to scale up and evaluate similar weight management interventions for this group are warranted.
    • Sodium and potassium intakes assessed by 24-h urine among Moroccan University students in Casablanca, Morocco: Cross-sectional study

      Elarbaoui, Maria; Jafri, Ali; Elkardi, Younes; Makhlouki, Houria; Ellahi, Basma; Derouiche, Abdelfettah; Hassan II University of Casablanca; Mohammed VI University of Health Sciences; University of Chester (Elsevier, 2022-06-14)
      In Morocco, the high consumption of dietary sodium increases the risk of non-communicable diseases (NCDs) and predisposes to cardiovascular diseases (CVDs) and hypertension. This study aims to assess the dietary sodium and potassium intake in a random sample of Moroccan adult students as a benchmark informing a national strategy for reducing salt intake. This cross-sectional study was conducted with 103 adults aged 18 to 25 years recruited in Casablanca. The 24-hour urinary excretion was used to measure the sodium and potassium. Urine volume and creatinine excretion level were used to validate the completeness of the collected samples. The average urinary sodium excretion was 3.1 ± 0.1 g/day, 13.5% consumed less than 5g/day, while 69% consumed more than 5 g/day of which 17.5% consumed more than twice the recommendations. For the average urinary potassium excretion was 1.83 ± 0.06 g/day, and more than 98% of the students consumed less than the adequate intake. The Na/K ratio is significantly higher than the recommended amounts. The results of this pilot study show that the population studied has a high sodium intake and low potassium intake which does not meet World Health Organization (WHO) recommendations, which requires implementing an action plan to reduce salt intake.
    • Home‐based care nurses’ lived experiences and perceived competency needs: A phenomenological study

      Rusli, Khairul Dzakirin Bin; orcid: 0000-0002-8096-0006; Fen, Ong Shu; Speed, Shaun; Seah, Betsy; McKenna, Lisa; orcid: 0000-0002-0437-6449; Ying, Lau; orcid: 0000-0002-8289-3441; Ying, Liaw Sok; orcid: 0000-0002-8326-4049 (Wiley, 2022-05-22)
    • Editorial: COVID-19-Social Science Research During a Pandemic

      Ward, Paul R.; Bissell, Paul; Meyer, Samantha B.; Gesesew, Hailay A.; Januraga, Pande Putu; Chang, Dukjin; Lombi, Linda; Torrens University; University of Chester; University of Waterloo; Mekelle University; Udayana University Denpasar; Seoul National University; Catholic University of the Sacred Heart (Frontiers Media, 2022-05-09)
    • Reassessing the health impacts of trade and investment agreements: a systematic review of quantitative studies, 2016–20

      Barlow, Pepita; Sanap, Rujuta; Garde, Amandine; Winters, L. Alan; Mabhala, Mwandile A.; Thow, Anne-Marie; London School of Economics and Political Science; Univeristy of Liverpool; University of Sussex Business School; University of Chester; University of Sydney
      To ensure a high level of health protection, governments must ensure that health and trade policy objectives are aligned. We conducted a systematic review of the health impacts of trade policies, including trade and investment agreements (TIAs), to provide a timely overview of this field. We systematically reviewed studies evaluating the health impacts of trade policies published between Jan 19, 2016, and July 10, 2020. Included studies were quantitative studies evaluating the impact of TIAs and trade policies on health determinants or outcomes. We evaluated methodological quality and performed a narrative synthesis. 21 of 28 067 articles identified via searches met our criteria. Methodologically strong studies found reduced child mortality, deteriorating worker health, rising supplies of sugar, ultra-processed food, tobacco, and alcohol supplies, and increased drug overdoses following trade reforms, compared with the time periods before trade reform. However, associations varied substantially across contexts and socioeconomic characteristics. Our findings show that trade policies, including TIAs, have diverse effects on health and health determinants. These effects vary substantially across contexts and socioeconomic groups. Governments seeking to adopt healthy trade policies should consider these updated findings to ensure that opportunities for health improvement are leveraged and widely shared, while harms are avoided, especially among vulnerable groups.
    • Coronavirus Disease (COVID-19): The Mental Health, Resilience, and Communication Resources for the Short- and Long-term Challenges Faced by Healthcare Workers

      Mitchell, Andrew E. P.; Keyworth, Chris; Salas, Eduardo; Galli, Federica; Vegni, Elena; University of Chester; University of Leeds; Rice University; Sapienza University; University of Milan
      The coronavirus disease pandemic has been an exceptional time for healthcare workers who have had to adapt to new ways of communicating with each other and delivering care to their patients. Maintaining healthcare workers’ well-being and mental health during increased COVID-19 workload pressure and change in practices is needed. It is essential to have a resilient workforce that can respond to the challenges presented by the pandemic. Healthcare workers at the frontline may be more susceptible to psychological stressors such as the availability of resources to protect themselves and their patients whilst balancing this with maintaining the health and well-being of family and friends. This research topic addresses the problems and issues researchers, policymakers, and educators face when formulating the best evidence and recommendations to support healthcare workers. There is a need to collate the best available practice and share knowledge from diverse contexts so healthcare workers can deliver the best care whilst they stay physically and mentally healthy.
    • Ageing, Sexual Orientation and Mental Health: Lesbian, Gay, Bisexual, Transgender and Intersex Older People

      Broadway-Horner, Matthew; University of Chester (Jessica Kingsley Publishers, 2017-02-21)
      Introduction Discrimination against lesbian, gay, bisexual, transgendered and intersex (LGBTi)i people can often mean they are denied the basic human right to live the life they are born to lead (Kimmel et al. 2006). Traditionally, LGBTi people have often had to live in secret, hidden from the dominant heterosexual society, and many older people are still worried about disclosing their sexual identity (Kimmel et al. 2006). In this chapter I will explore some of the many issues facing older LGBTi people. The chapter starts with a brief overview of the history of the LGBTi communities and how they have been treated as ‘invisible citizens’ through mechanisms of the law and the medicalisation of the ‘homosexual’ (Jennings 2007). Then I examine some of the fears and concerns held by members of LGBTi communities when accessing services, and this is discussed in relation to issues of sexuality, mental health and ageing. It is my hope that in reading this chapter you will gain a deeper understanding of the issues raised and then think of areas of application for your own development as a non-discriminatory practitioner, as well as identifying needs for further service development